title: General immune dampening is associated with disturbed metabolism at diagnosis of type 1 diabetes.
abstract: BACKGROUND
  Type 1 diabetes (T1D) is a serious diagnosis with the prospect of grave short- and long-term complications and even death if poorly managed. An attempt has been made to describe how clinical and immunological deviations might influence each other close to the diagnosis of T1D.
  
  
  METHODS
  Sixty-nine newly diagnosed T1D children were studied together with a reference group of 30 healthy children. Cytokines (interleukin (IL)-6, IL-10, IL-13, IL-17, interferon-γ, and tumor necrosis factor-α) were detected in in vitro culture by multiplex fluorochrome technique. Information of clinical status of the patients such as BMI, weight loss, pubertal stage, duration of symptoms, previous and/or ongoing infections, insulin requirement, and ketoacidosis were gathered together with the analysis of C-peptide and glycosylated hemoglobin (HbA1c).
  
  
  RESULTS
  In general, low cytokine secretion was found at diagnosis of T1D. However, high C-peptide, short duration of symptoms, or an infection prior to diagnosis was associated with increased immune activity including proinflammatory, Th2-associated, and Tr1-associated cytokines. In contrast, ketoacidosis and later pubertal stage at onset of disease were more related to a Th1-prone response.
  
  
  CONCLUSIONS
  There is a general immune dampening at diagnosis of T1D, which appears to be related to the metabolic state close to diagnosis.
authors.affiliation: 1] Division of Paediatrics and Diabetes Research Centre, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden [2] Type 1 Diabetes R&D Center, Novo Nordisk, Seattle, Washington [3] Pacific Northwest Diabetes Research Institute, Seattle, Washington.
authors.forename: Anna
authors.initials: A
authors.lastname: Rydén
authors.affiliation: Division of Paediatrics and Diabetes Research Centre, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Johnny
authors.initials: J
authors.lastname: Ludvigsson
authors.affiliation: Linköping Academic Research Center, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Fredrikson
authors.affiliation: 1] Biomedical Platform, Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Jönköping, Sweden [2] Division of Medical Diagnostics, Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Faresjö
mesh_terms: D000293:Adolescent; D001324:Autoantigens / Q000276:immunology; D002096:C-Peptide / Q000378:metabolism; D002648:Child; D016207:Cytokines / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D007662:Ketosis / Q000378:metabolism; D011627:Puberty
chemical_list: D001324:Autoantigens; D002096:C-Peptide; D016207:Cytokines